Infographic: 12 steps of the workers’ compensation legal process

To many, a job can mean making sure you and your family live comfortably day to day. So, when a work injury occurs, you want to make sure you and your family will be taken care of if you are not able to work.

The employer will give the employee a Workers’ Compensation Claim Form (DWC-1), which the employee must fill out and bring back to the employer within 30 days.

The employer’s insurance must authorize medical treatment within 1 day and submit a comp claim to your insurer within 5 days.

Within 14 days, the insurer will send your employer a notice notify you whether your workers’ comp claim has been denied, delayed, or accepted.

If denied, all benefits will stop. If delayed, the insurer will have up to 90 days to investigate, and medical treatment will continue. If accepted, you’ll receive workers’ compensation indemnity benefits and medical treatment.

If denied, the parties must try the issue for the denial before the case can proceed.

Once medical discovery is complete, the parties start settlement negotiations. If settlement negotiations are unsuccessful, the parties will have a Mandatory Settlement Conference.

If the parties cannot settle at the Mandatory Settlement Conference, the case proceeds to trial.

A workers’ compensation case can settle by either a lump sum amount or weekly payments with lifetime medical care.

Workers’ Compensation Claim Filing Process

Similarly, the workers’ compensation claim filing process can be daunting and complicated. That’s why it’s always good to have a dedicated workers’ compensation legal team on your side to help you through the many different complications associated with any form of claim filing process.

The very first step in the workers’ compensation claim filing process is to file an injury report with your employer. Without filing an injury report, there is no legal record of your work injury. This should always be the first step in the claim process because otherwise, there will be no official record of the injury and proceeding with the case will be exceptionally difficult. Never wait to file your report, either. Always get the paperwork done as close to the date of the injury as possible.

Step Two: File Your Compensation Claim

After you have filed your injury report with your employer, you must file a workers’ compensation claim. Be very descriptive in your claim. Include in your claim things like names of witnesses to the injury, medical records and any other details that pertain to your injury and case. The more detailed you are in your report, the more weight your case will likely carry.

Step Three: Get A Medical Exam

Often, the employer and/or their insurance provider will require that you, the injured party, to undergo a medical examination. This is so that they can determine whether or not your injury claim is valid. If eligible, the insurance company should allocate benefits. Generally, after this initial medical examination, it is a good idea to seek a second opinion. Unfortunately, there have been situations where the medical examiner chosen by the employer and/or their insurance company has been extremely biased. Getting a second professional medical examination helps to keep that from happening.

Lastly, it’s important to contact a workers’ compensation lawyer. If any of the steps above seem confusing, or if benefits are not being provided, don’t worry — our legal team can help guide you through the paperwork and legal terminology.

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If you or a someone you know needs assistance with a potential accident, injury or workers’ compensation case, call the lawyers at Chain | Cohn | Stiles for a free consultation at 661-323-4000, or visit the website chainlaw.com.

*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.

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*NOTICE: Making a false or fraudulent Workers’ Compensation claim is a felony subject to up to 5 years in a prison or a fine of up to $150,000 or double the value of the fraud, whichever is greater, or by both imprisonment and fine.